Posts Tagged ‘Women in medicine’

How reporter Jan Hoffman and the New York Times manage to insult female physicians and get their facts about anesthesia so wrong all at the same time.

My husband and I, both anesthesiologists, enjoy our Sunday mornings together — coffee, the New York Times, a leisurely breakfast. No rush to arrive in the operating room before many people are even awake.

Today, though, seeing reporter Jan Hoffman’s front-page article in the Times — “Staying Awake for Your Surgery?” — was enough to take the sparkle out of the sugar. Her article on how much better it is to be awake than asleep for surgery reminded me why I left a plum job as a reporter for The Wall Street Journal to go to medical school — because reporters have to do a quick, superficial job of covering complex issues. They aren’t experts, but seldom admit it.

Physician anesthesiologists across the country are likely to face patients on Monday morning who wonder if they ought to be awake for their surgery. The answer to that question may well be “no”. But according to Ms. Hoffman, that answer reflects “physician paternalism”, and makes us opponents of the “patient autonomy movement”, because a patient should have the right to choose to be awake.

It’s not that simple.

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Dr. Margaret Wood, who chairs the Department of Anesthesiology at Columbia University Medical Center, has published a wonderful article titled “Women in Medicine:  Then and Now“, in the journal Anesthesia and Analgesia.

I think I speak for many of us in admitting that Anesthesia and Analgesia doesn’t occupy a prominent place on my bedside table. Many readers may have missed Dr. Wood’s article. That’s a shame, because it isn’t just about anesthesiology, and speaks to issues in medicine independent of specialty or gender. Here are some of my favorite passages about lessons she learned over the course of her long and successful career:

“1. It is important to have a passion for what you do if you strive for excellence. If you have that passion, then the efforts do not feel like a sacrifice and “burnout” is not an issue. I cannot imagine that Virginia Apgar spent a single moment talking, thinking, or worrying about burnout.

2. The current fashion to complain about “life balance” can be self-destructive; however, pacing oneself is critical. You can have it all, just not all at once. The Chairman of Anatomy gave the inaugural lecture to my incoming class of medical students. His thesis was that as a physician/medical student you could have (i) an active time-consuming social life, (ii) a family, and (iii) a career, but to be successful you should have no more than two of these at the same time. I believe this to be true and have followed this advice since.

3. Women should be careful not to fall into the trap of feeling entitled to special considerations or engage in special pleadings. Our patients want their physician to be the best, whatever his or her sex. There is no room for a physician of either sex who is less qualified or less committed because of outside responsibilities.

4. Women no longer need to “prove themselves” against the sea of doubters who dominated medicine 40 years ago. Fortunately, we are now past that point and such doubts, are I hope, antediluvian. Women are where they are today, however, because many of us felt that demonstrating that women really could “do it” was a moral imperative and one to which we were fully committed.

5. Parents need to manage their work and family responsibilities to ensure that both receive their full attention. This will often mean ensuring that they have excellent childcare to allow them to have the confidence to focus on work when that is required. This may be expensive, but it is a critical investment by both parents in their family’s future. Successfully raising children is a joint responsibility of both partners; what is critical to women is also critical to men, and vice versa. Women starting out on this journey can be assured that it is possible to raise well-adjusted children in a home in which both partners have challenging and successful careers, provided there is a true partnership in the family.”

Is Dr. Wood a curmudgeon, or perhaps a dinosaur? That could be, but I find her honesty refreshing.

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Of cats and termites

How an eleven-pound cat precipitated domestic chaos and delayed surgery

Termites are endemic in southern California, and we’ve had spot treatments several times over the years at various sites in our house where little piles of sawdust have appeared as evidence of termite activity. Finally it became clear that the termites were winning and more aggressive treatment was in order: tenting. This is the process of hoisting a big, brightly-colored tent over the whole house and putting an end to the termites with a poisonous gas called Vikane, or sulfuryl fluoride.

Tenting is a major project. All food and medicine has to be put in special non-porous plastic bags, sealed tightly with tape. All the people, animals and plants have to be evacuated. Natural gas must be turned off. The house is sealed in the tent for 24 hours, then aired out with big industrial fans. On the third day, you can go home.

The fumigation was scheduled to begin on Monday. Over the weekend, we put the food and medicines in bags, or most of it anyway. I arranged for our three tabby cats to be boarded at the vet. Our dog-walker agreed to board Milo, our 100 lb. Rottweiler-mix dog, at her house. My husband Steve complained continuously, as though I had bought bags of termites and sprinkled them around the house on purpose to annoy him.

On Monday morning Steve and I both went to work, to our day jobs as anesthesiologists, and I came home at 11:30 to take the cats to the vet and hand off the dog. The exterminators were expected to arrive between 1:30 and 3:30 pm. I had the presence of mind to lock all three cats in the family room before I went to work. Now my task was to get all three into their carriers and off to the vet.

Going three rounds with Tigger

I decided to tackle Tigger, the five-year-old male, first. He is strong, sinewy and sleek, and we’ve nicknamed him the “stealth cat” because he is very good at eluding capture. I thought he would be the biggest challenge to put in the carrier, and I was right.

Round 1. I caught Tigger, shoved him into his carrier, and tried to hold him down while I zipped it up. He turned into a writhing yowling clawing dervish and fought his way out.

Round 2. I think he got out even faster that time.

Round 3. Met the definition of insanity, as I hoped for a different outcome from the same sequence of actions. Same cat, same outcome.

I considered my options, and decided to get Joe and Tabitha into their carriers and drive them to the vet. This, I thought, would give Tigger time to calm down. Joe is a placid 17-year-old senior cat, and while he doesn’t like to go anywhere, he can’t be bothered to put up much fuss. Tabitha is a 10-month old kitten. It took some doing to catch her, and she was very unhappy, but she was still too small to win the contest. I drove Joe and Tabitha to the vet and came back home. As I came in the house, I caught a brief glimpse of Tigger, still locked in the family room. I put some more food in bags and waited for Krys, the dog-walker, to arrive and help me with Tigger.

1 pm: Krys arrived. We discussed the plan to put Tigger in his carrier. Only problem: we couldn’t find Tigger. We looked all over the family room and kitchen. We searched in the coat closet, under furniture, and behind the washing machine and dryer. No Tigger. It was as if he had evaporated. Milo (the dog) at this point was becoming anxious, trotting around after me and panting, sensing a disturbance in the force. I decided it would be best to let Krys and Milo leave.

1:30 pm: A fair amount of stuff still needed to be put in bags, but I couldn’t find the cat anywhere. Rising anxiety. I called my husband. A veteran of married life, he recognized the tone of desperation in my voice, and promised to come home as soon as he could arrange coverage. Cat clearly more important (for the moment) than heart surgery.

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